Changes in Medicare costs with the growth of hospice care in nursing homes.

ABSTRACT:

Background

Nursing home residents' use of hospice has substantially increased. Whether this increase in hospice use reduces end-of-life expenditures is unknown.

Methods

The expansion of hospice between 2004 and 2009 created a natural experiment, allowing us to conduct a difference-in-differences matched analysis to examine changes in Medicare expenditures in the last year of life that were associated with this expansion. We also assessed intensive care unit (ICU) use in the last 30 days of life and, for patients with advanced dementia, feeding-tube use and hospital transfers within the last 90 days of life. We compared a subset of hospice users from 2009, whose use of hospice was attributed to hospice expansion, with a matched subset of non-hospice users from 2004, who were

SUBMITTER: Gozalo P 

PROVIDER: S-EPMC4465278 | biostudies-literature | 2015 May

REPOSITORIES: biostudies-literature